Fernando Arias, MD, FACS1, Sergio Augusto Cáceres-Maldonado2, Alexandra Bastidas, MD2, Daniel Guerra2. 1University Hospital Fundación Santafé de Bogotá Bogotá, Colombia, 2Faculty of Medicine University of the Andes Bogotá, Colombia
Introduction: The aim of this study is to evaluate early outcomes when performing SILS for emergency abdominal surgical conditions in our hospital.
Methods and Procedures: Patients who visited the emergency department and underwent a surgical abdominal emergency procedure at the University Hospital Fundación Santafé de Bogotá (Bogotá DC, Colombia) by our group using a SILS technique were included for analysis. Data was collected from July 2008 through July 2017. Outcomes regarding length of surgery, hospital stay, operative complications (classified following the Accordion Severity Grading System parameters), conversion rates and reintervention were analyzed descriptively.
Results: A total of 593 patients and 644 procedures from the registry met our inclusion criteria. Female patients accounted for 55.8% (331) of the sample. The most common procedures performed were appendectomies (405; 62.9%), followed by cholecystectomies (134; 20.8%), and adhesiolysis for bowel obstruction (37; 5.7%). Other procedures included emergency hernia repairs (16; 2.5%), bowel resections (15; 2.3%), and perforated ulcer repairs (3; 0.5%) amongst others. Total surgical time was under 2 hours on 90% of procedures, and 75% of procedures were discharged home on the first 24 hours. A total of 34 (5.1% of procedures) postoperative complications were reported classified as follows: 16 mild, 11 moderate, and 7 severe, 6 of which underwent surgery. Finally, we report a total of 9 (1.5%) readmissions and 6 (1%) reinterventions all within the first 30 days after surgery. Reinterventions were performed for drainage of surgical infections on 2 cases (abdominal collections), bowel obstruction on 2 cases and 2 cases of wound dehiscence. One procedure was converted to multi-port and none to open surgery. No cases of 30-day-mortality were identified on the registry.
Conclusions: SILS is an alternative to multiport laparoscopic surgery, but most institutions nowadays perform the SILS approach only in selected elective procedures. We analyzed the outcomes of SILS in an acute care setting showing complication rates comparable to those in standard multiport laparoscopy. It is important to emphasize how the expertise of the surgeon is critical towards obtaining appropriate results with SILS.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88370
Program Number: P060
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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